Serum Albumin Levels Research Articles

The role of ischaemia-modified albumin in the prognosis of acute pancreatitis and its correlation with the NF-κB-mediated inflammatory response.

To investigate the correlation between the serum levels of ischaemia-modified albumin (IMA) and disease severity in rats with acute pancreatitis (AP). A rat AP model was established and blood samples from each group were analysed at different time points. After the experiment, the pancreatic tissues of the rats were collected for pathological examination and the measurement of protein levels of NF-κB and NF-κB p65. Serum levels of amylase (α-AMY), tumour necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-8 were also compared between groups of rats. The serum IMA concentration in the severe acute pancreatitis (SAP) group was greater than that in the mild acute pancreatitis (MAP) group. The levels of the NF-κB and NF-κB p65 proteins were increased in the MAP and SAP groups in a time-dependent manner. α-AMY, TNF-α and IL-6 were increased at all time points in the MAP and SAP groups. The increases were greatest at 24 h in the SAP group. In terms of pathological changes in the pancreas, renal and lung tissues, the damage in the SAP group was more obvious than that in the MAP group. Serum IMA level was associated with inflammatory markers and NF-κB p65 in rats with AP.

Subacute Toxicity and Pharmacokinetic Evaluation of the Synthetic Cannabinoid 4F-MDMB-BUTINACA in Rats: A Forensic and Toxicological Perspective

Background: 4-MDMB-BUTINACA, a next-generation synthetic cannabinoid, presents significant public health and forensic challenges due to its evolving nature and potential toxicity. Methods: This study evaluates the subacute toxic effects and pharmacokinetics of 4−Fluoro MDMB−BUTINACA (4F-MDMB-BUTINACA) in adult male albino rats, administered orally for seven days at doses of 1 mg/kg, 5 mg/kg, and 15 mg/kg. The hematological, biochemical, and histopathological parameters were assessed and compared to controls. Results: The pharmacokinetics were determined using GC–MS/MS with a positive chemical ionization and granisetron as an internal standard. A histological analysis revealed inflammatory cell aggregation, congestion, hemorrhage, edema, and fibrosis in various tissues, with renal examinations showing tubule degradation, glomerular atrophy, Bowman’s space expansion, edema, and hemorrhage. The liver exhibited cellular infiltration, while cardiac muscle fibers showed myocardial fiber degradation and inflammatory cell aggregation. Biochemical assays indicated significant alterations (p < 0.05) in the serum levels of AST, ALT, ALP, GGT, total protein, albumin, triglycerides, urea, MCHC, MCV, RDW, platelets, neutrophils, eosinophils, and basophils compared to the controls. Conclusions: The validated bioanalytical method revealed rapid absorption of 4F-MDMB-BUTINACA, with a plasma half-life of 2.371 h, a volume of distribution of 2272.85 L, and a plasma clearance rate of 664.241 L/h. In conclusion, 4F-MDMB-BUTINACA is a highly toxic synthetic cannabinoid, particularly affecting the liver, kidneys, and heart.

Impact of Silver Nanoparticles (Ag-NPs) as a Dietary Supplement on Growth Performance, Carcass Traits, Blood Metabolites, Digestive Enzymes, and Cecal Microbiota of Growing Rabbits

Abstract The present study investigated the impact of silver nanoparticles (Ag-NPs) on growth performance, carcass traits, liver and kidney functions, immunity and antioxidant indicators, digestive enzymes, and cecum bacteriology of growing rabbits. One hundred 5-week-old New Zealand White (NZW) male rabbits were randomly divided into 5 equal groups and fed for 8 weeks on the basal diet only or on the basal diet supplemented with different levels of Ag-NPs (0.25, 0.50, 0.75, or 1.00 mg/kg diet). Animals in each group were randomly distributed in 10 cages (replicates), with two rabbits each. Different dietary concentrations of Ag-NPs significantly increased live body weight (LBW) and feed conversion ratio (FCR). Also, body weight gain (BWG) increased dramatically during all experimental periods except 11–13 weeks of age. Levels of 0.25 and 1 mg of Ag-NPs/kg diet showed the highest increase in LBW, BWG, and FCR. All studied carcass traits, except liver %, were not affected by Ag-NPs levels. Rabbits fed diet supplemented with 1 mg Ag-NPs had the highest liver %. Serum total protein, albumin, and globulin levels were increased (P<0.05) in groups treated with 0.25 and 0.75 mg Ag-NPs. In contrast, serum values of aspartate transaminase (AST) and alanine transaminase (ALT), urea and creatinine were significantly reduced with the supplementation of Ag-NPs up to 0.75 mg/kg diet. The immunoglobulins M, G, and A (IgM, IgG, and IgA), complement 3 (C3) and lysozyme activity were improved with the inclusion of nano-silver in the rabbit feeds, particularly at the level of 0.25 mg Ag-NPs/kg feed. The inclusion of Ag-NPs in rabbit diets at different concentrations increased the total antioxidant capacity and the activities of superoxide dismutase, catalase, and glutathione peroxidase. Growing rabbits fed on diets supplemented with Ag-NPs had higher levels of digestive enzymes than the control group. The addition of Ag-NPs reduced the load of E. coli, Salmonella spp. and coliform in the rabbit cecum. Overall, the inclusion of 0.25–1 mg Ag-NPs/kg to NZW rabbit diets has shown beneficial effects on health and performance.

Difference in hematocrit and plasma albumin levels as an early biomarker of severity and prognosis in patients with severe fever and thrombocytopenia syndrome.

Severe fever with thrombocytopenia syndrome (SFTS) is a widespread infectious disease with high mortality. Hence, identifying valuable biomarkers for detecting the early changes in SFTS is crucial. In this study, we investigated the relationship between the difference in hematocrit (HCT) and serum albumin (ALB) levels (HCT-ALB) and the prognosis of patients with SFTS virus infection. After excluding the patients who did not meet the SFTS diagnostic criteria, those with SFTS from the First Affiliated Hospital of Wannan Medical College were divided into a fatal and Nonfatal group based on their disease prognosis. A dynamic analysis of the daily laboratory data was conducted for 14 days following SFTS onset. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of HCT-ALB. Another sample of patients with SFTS admitted to the First Affiliated Hospital of Nanjing Medical University was utilized to verify the study conclusions. A total of 158 patients with SFTS were included. Among them, 126 patients were categorized in the Nonfatal group and 32 in the fatal group, leading to a mortality rate of 20.25% (32/158). Univariate analysis of the laboratory test findings and ROC curve analysis showed that alanine aminotransferase (ALT), aspartate aminotransferase (AST), HCT-ALB, and lactate dehydrogenase (LDH) had a relatively better ability to discriminate the disease condition of the patients with SFTS. Moreover, HCT-ALB served as a predictor of SFTS prognosis. Additionally, an area under the ROC curve (AUC) of 0.777 and a critical HCT-ALB value of 4.75 on day 7 were associated with a sensitivity of 83.3% and a specificity of 73.9%. On day 8 (AUC = 0.882), the critical value of HCT-ALB was 9.25, while the sensitivity was 100% and specificity was 76.5%. Further verification based on the data of 91 patients with SFTS admitted to the First Affiliated Hospital of Nanjing Medical University demonstrated a mortality rate of 51% (24/47) among those with HCT-ALB values >4.75 on day 7 of the disease course, highlighting the potential of the HCT-ALB value of >4.75 for predicting SFTS prognosis. High HCT-ALB values are closely related to the mortality of patients with SFTS. HCT-ALB is a sensitive and independent predictor of early disease in patients with SFTS.

Risk factors and clinical impact of seroma formation following laparoscopic inguinal hernia repair: a retrospective study

BackgroundAlthough laparoscopic inguinal hernia repair (LIHR) has advantages over open surgery, postoperative seroma formation remains an issue. This study aimed to investigate the risk factors and clinical outcomes of seroma formation in patients undergoing LIHR.MethodsFrom January 2016 to March 2023, clinical data of patients who underwent LIHR were retrospectively analyzed. Patients who developed seroma and those who did not were classified into the seroma and non-seroma groups, respectively. The demographic and clinical characteristics were compared between the two groups. Univariate and multivariate logistic regression analyses were performed for variables of interest. The receiver operating characteristic curve was used to evaluate the risk factors of the binary logistic model, and the cutoff value for each risk factor was obtained.ResultsData of 128 patients were evaluated. Compared with patients in the non-seroma group, those in the seroma group had a higher body mass index (BMI) (P < 0.001), more direct hernias (P < 0.001), larger hernial orifice size (P < 0.001), more laparoscopic total extraperitoneal hernioplasty (TEP) (P < 0.001), more frequent reduction of hernial sac (P = 0.011), and lower preoperative serum albumin level (PSAL) (P < 0.001). Multivariate logistic regression analyses performed on these variables showed that high BMI (P = 0.005), large hernial orifice (P = 0.001), TEP (P = 0.033), and low PSAL (P = 0.009) were risk factors for seroma formation. Compared with the non-seroma group, the seroma group exhibited a higher numerical rating scale score for postoperative pain (P < 0.001), and longer hospital stays (P = 0.032).ConclusionsBMI (> 24.5 kg/m2), hernial orifice size (> 2.5 cm), TEP, and PSAL (< 32.5 g/L) were independent risk factors of postoperative seroma formation in patients who underwent LIHR. Although most seromas resolve spontaneously without surgical intervention, seroma formation results in increased patient pain and prolonged hospital stay.

Curcumin and its combination with a reduced dose of rosuvastatin: A promising therapy for chronic kidney disease and associated dyslipidemia in rat animal models.

The objective of this study was to confirm the effects of curcumin and to investigate the effects of its combination with a reduced dose of rosuvastatin in an adenine-induced model of chronic kidney disease (CKD) and associated dyslipidemia in rats. Renal function and morphology, as well as lipid status, were assessed using laboratory parameters and histopathological analysis. Male Wistar rats (n=36) randomly divided into six groups, were treated for 24 days: normal control (standard diet), CKD control (adenine diet, 0.75% w/w adenine-supplemented diet), curcumin (100 mg/kg/day + adenine diet), rosuvastatin minimal therapeutic dose (MTD) (5 mg/day + adenine diet), rosuvastatin reduced dose (RD, 25% of rosuvastatin MTD + adenine diet), and rosuvastatin RD + curcumin (25% of rosuvastatin MTD + curcumin 100 mg/kg/day + adenine diet) group. While rosuvastatin alone showed only antilipemic action, both curcumin alone and its combination with a reduced dose of rosuvastatin showed better renal protection with lower serum creatinine levels and milder renal morphological alterations, as well as better antilipemic action with lower levels of triglycerides, very low-density lipoprotein (VLDL), and low-density lipoprotein (LDL) cholesterols compared with the levels in CKD control rats. Treatment with curcumin alone also resulted in a significantly higher estimated glomerular filtration rate, lower uric acid levels, and higher high-density lipoprotein (HDL) cholesterol, while the combined therapy additionally resulted in higher serum albumin levels, lower total cholesterol, and both atherogenic and coronary risk indexes compared with CKD control rats. The results of this study confirmed the beneficial effects of curcumin alone and provided new evidence for the beneficial effects of its combination with a reduced dose of rosuvastatin in rats with CKD and associated dyslipidemia.

Observational study of immunosuppressive treatment patterns and outcomes in primary membranous nephropathy: a multicenter retrospective analysis

BackgroundWe evaluated the efficacy of different immunosuppressive regimens in patients with primary membranous nephropathy in a large national cohort.MethodsIn this registry study, 558 patients from 47 centers who were treated with at least one immunosuppressive agent and had adequate follow-up data were included. Primary outcome was defined as complete (CR) or partial remission (PR). Secondary composite outcome was at least a 50% reduction in estimated glomerular filtration (eGFR), initiation of kidney replacement therapies, development of stage 5 chronic kidney disease, or death.ResultsMedian age at diagnosis was 48 (IQR: 37–57) years, and 358 (64.2%) were male. Patients were followed for a median of 24 (IQR: 12–60) months. Calcineurin inhibitors (CNIs) with or without glucocorticoids were the most commonly used regimen (43.4%), followed by glucocorticoids and cyclophosphamide (GC-CYC) (39.6%), glucocorticoid monotherapy (25.8%), and rituximab (RTX) (9.1%). Overall remission rate was 66.1% (CR 26.7%, PR 39.4%), and 59 (10.6%) patients reached secondary composite outcome. Multivariate logistic regression showed that baseline eGFR (OR 1.011, 95% CI: 1.003–1.019, p = 0.007), serum albumin (OR 1.682, 95% CI: 1.269–2.231, p < 0.001), and use of RTX (OR 0.296, 95% CI: 0.157–0.557, p < 0.001) were associated with remission rates; whereas only lower baseline hemoglobin was significantly associated with secondary composite outcome (OR: 0.843, 95% CI: 0.715–0.993, p = 0.041). CYC use was significantly associated with higher remission (OR 1.534, 95% CI: 1.027–2.290, p = 0.036).ConclusionsHigher baseline eGFR and serum albumin levels correlated with increased remission rates. Remission rates were lower in patients treated with RTX, while those on GC-CYC showed higher rates of remission. Due to the study’s retrospective nature and multiple treatments used, caution is warranted in interpreting these findings.

Correlation between Serum Albumin Level and Severity of Acute Ischemic Stroke : A Cross-Sectional Study

Introduction: Stroke is a leading cause of disability with devastating consequences. Serum albumin has emerged as a significant prognostic marker in various conditions, including stroke. This study aims to investigate the relationship between serum albumin levels and stroke severity and outcomes in patients with acute ischemic stroke (AIS).Methods: An observational, cross-sectional study was conducted over six months at Bir Hospital, among patients admitted in medicine ward. Total population sampling was done. Serum albumin at the time of diagnosis was measured. Ischemic stroke severity was scored based on NIHSS score on admission and the functional outcome was evaluated as modified Rankin Scale (mRS). Finally, correlation of serum albumin with the severity and the outcome of stroke (mRS) was made.Results: The study of 37 patients showed significant correlation between serum albumin and NIHS score. For high severity (NIHSS≥10), logistic regression analysis identified (OR: 0.086; 95% CI: 0.01-0.75, p-value 0.027) indicating there is strong association between serum albumin and NIHSS score (or severity). The study showed significant correlation between serum albumin and modified Rankin scale at the 0.01 level (2 tailed). The mean serum albumin level was 0.364 units higher (95% CI: 0.103 to 0.625) units higher in non-poor mRS score compared to poor mRS score. P-value of 0.003 suggested strong association between Serum albumin and mRS score.Conclusion: Significant correlation of serum albumin level with clinical severity at the time of admission and with the outcome during discharge was found. Thus serum albumin has prognostic significance in acute ischemic stroke.

Evaluating The Factors Affecting Mortality and Survival of the Patients Who Underwent Percutaneous Endoscopic Gastrostomy; The Short-term and Long-term Results

Summary Aim Percutaneous endoscopic gastrostomy (PEG) is a common minimally invasive technique performed in patients with oral feeding problems. The aim of the current study is to evaluate the associated factors that have an impact on the short- and long-term survival and mortality in these patients who received PEG tube placement. Materials and Methods The patients who underwent PEG placement between June 2020 and June 2023 are enrolled in the study. Mortality data was extracted from the National Death Registry database. Data regarding the demographics, indications of PEG, co-morbidities, length of hospital stay prior to PEG procedure, the need for mechanical ventilator support, body-mass index, serum levels of hemoglobin, leukocyte, albumin, and c-reactive protein are extracted retrospectively. Kaplan Meier and Cox regression analyses were used to evaluate the factors affecting survival. Results A total of 137 patients are enrolled in the study (71 female and 66 male). One-month mortality was 16.7% and overall mortality during a follow-up of 38 months was 51%. Survival was significantly higher in patients with motor neuron diseases than the patients with Alzheimer’s (p=0.036). Length of hospital stay before PEG placement and hemoglobin levels were found to have a significant impact on survival in Cox regression analysis (p=0.000, p=0,009). Conclusion Length of hospital stay before PEGplacement, need for mechanical ventilator support and hemoglobin levels were found significantly associated with survival. Higher mortality in Alzheimer's patients may indicate that indications of PEG should be re-evaluated in these patients.

Effects of Beraprost on Intestinal Microcirculation and Barrier Function in a Mouse Model of Renal Failure.

Endothelial dysfunction plays an important role in the pathogenesis of chronic kidney disease. Prostacyclin (PGI2), an endothelial cell-produced endogenous prostaglandin, plays a crucial role in maintaining endothelial function. However, its effects on intestinal microcirculation and barrier function are not fully understood. We hypothesized that PGI2 improves intestinal microcirculation and barrier function via endothelial protective effects. ICR and ICGN (a spontaneous nephrotic model) mice were used in this study. Intestinal microcirculation was visualized invivo to investigate PGI2 effects. Beraprost served as PGI2. PGI2 administration spanned 4 weeks, following which we assessed its influence on intestinal endothelial, intestinal barrier, and renal functions. We visualized intestinal microcirculation and endothelial glycocalyx in the intestinal blood vessels. Beraprost administration induced a 1.2-fold dilatation of the vascular diameter of the small intestine. Intestinal blood flow in ICGN mice was significantly reduced compared that in ICR mice but improved with beraprost administration. ICGN mice exhibited reduced serum albumin levels, decreased ambulation, an imbalance in intestinal reactive oxygen species (ROS)/nitric oxide (NO), and impaired tight junctions; all were ameliorated by beraprost administration. Beraprost improves intestinal microcirculation and barrier function by ameliorating ROS/NO imbalances, thereby reducing physical inactivity during renal failure.

CEREBRAL MICROVASCULATURE IN AN EXCLUSIVELY FAT DIET MODEL

The microcirculation system plays a major role in the process of food intake and assimilation by the body. It ensures the distribution of oxygen and nutrients among neurons, taking into account their functional activity. The capillaries of the villi in the choroid plexus of cerebral ventricles remain the main source of cerebrospinal fluid production, which determines most physiological functions of the body. The aim of the study is to identify the peculiarities of remodeling of the microvasculature and vascular plexus of the third cerebral ventricle in rats kept exclusively on a fat diet. Materials and Methods. The work was performed on 20 white mongrel male rats (200–250 g.), divided into control and experimental groups. Animals of the control group were on a regular diet. Rats of the experimental group were fed exclusively with fatty food (sheep tail fat). On the 15th and 30th days, the animals were withdrawn from the experiment. A study of biochemical blood parameters (cholesterol, glucose, and protein) was carried out. After decapitation, the brain was fixed in formalin, brain sections were stained with hematoxylin and eosin (Van Gieson stain). The authors conducted light microscopy and morphometry on an Olympus B×40 microscope (Japan). Results. The animals showed a significant increase in the levels of cholesterol, glucose and albumin in the blood serum under an exclusively fat diet. By the 30th day of the experiment, the smooth muscles of the cerebral arteries undergo paresis, proteolysis, vacuolar dystrophy, hypoplasia with a sharp expansion of the vessel lumen. Signs of myoelastofibrosis are observed in the adventitia. Vein walls are thinned, the lumen is dilated, intravascular thrombi are observed. In the choroid plexus of the 3rd cerebral ventricle, a deficit of plasma flow through the sinusoidal capillaries with compensatory ependymocyte hyperfunction is noted. Conclusion. An exclusively fat diet leads to remodeling of the cerebral microvasculature, including the capillaries of the villi of the choroid plexus of the 3rd ventricle. All changes are compensatory and adaptive in nature. However, by the 30th day of the experiment, some of them become irreversible.

Dynamic Soluble IL-6R/Soluble gp130 Ratio as a Potential Indicator for the Prostate Malignancy Phenotype-A Multicenter Case-Control Study.

Prostate tumors, if prostate cancer or adenoma, represent a major public health challenge. Progress in research on inflammation has revealed a connection between inflammation, immunity, and cancer. In this context, this study aimed to find IL-6 signaling systemic abnormalities in the inflammatory tumor microenvironment. This study was case-controlled, multicentered, and included 86 patients, 43 diagnosed with BPH and 43 diagnosed with PCa, between January 2019 and January 2020. The study group was homogenous and the studied parameters were IL-6 complex (IL-6, soluble receptor IL-6R, soluble glycoprotein gp130), acute phase proteins (C reactive protein-CRP, acid alpha1 glycoprotein-AGPA, ferritin, albumin, transferrin), and oxidative stress-associated variables (malondialdehyde-MDA, carbonylated protein-PCO, 8-hydroxy-deoxy guanosine-8-OHdG, total antioxidant status-bTAS). The inflammatory microenvironment determined IL-6 signaling alterations (over-regulation of sIL-6R and suppression of sgp130 in PCa versus BPH), changes in acute phase reaction markers (increased serum levels of CRP, AGPA, ferritin, and decreased serum levels of albumin, transferrin) that were much more evident in PCa compared to BPH, an imbalance between macromolecular oxidative damage (MDA, PCO, 8-OHdG) and endogenous antioxidants (TAS) that was more accentuated in PCa compared with BPH, and a representative association between the sIL-6R/sgp130 ratio and inflammatory/oxidative stress-related factors only in PCa patients. Our study reconfirms the anterior concept that IL-6 promotes prostatic tumorigenesis. In this study, we first demonstrated that a high sIL-6R/sgp130 ratio facilitates prostate malignancy.

Association between Serum Zinc and All-Cause Mortality in Patients Undergoing Maintenance Hemodialysis: The Osaka Dialysis Complication Study (ODCS).

Zinc is an essential microelement, and its deficiency is common in patients undergoing hemodialysis. However, the association between serum zinc and mortality in these patients remains unclear. The aim of this study was to explore the possible association between serum zinc levels and all-cause mortality in prevalent patients with kidney failure on maintenance hemodialysis. This was a prospective cohort study of maintenance hemodialysis patients followed up for 5 years. The key exposure was serum zinc level measured at baseline, and the outcome was all-cause mortality. Their association was analyzed using Cox proportional hazard models. Among 1662 eligible patients selected for this analysis, 468 (28%) died. Lower serum zinc levels were associated with a higher risk for mortality, independent of the major demographic factors and factors including mineral and bone disorder and renal anemia. However, this association was no longer significant when adjusted for serum albumin. Because there was a close correlation between serum zinc and albumin levels, we performed further analyses in which participants were categorized into four groups by median serum zinc (68 µg/dL) and albumin (3.7 g/dL) levels. In the lower serum albumin groups, risk of death was significantly higher in those with lower zinc than those with higher zinc levels, whereas such a difference was not significant in the high serum albumin groups. In patients undergoing maintenance hemodialysis with lower serum albumin levels, a lower serum zinc level was associated with a higher risk of mortality.

Cabozantinib prevents the progression of metabolic dysfunction-associated steatohepatitis by inhibiting the activation of hepatic stellate cell and macrophage and attenuating angiogenic activity

Cabozantinib, a multiple tyrosine kinase inhibitor targeting AXL, vascular endothelial growth factor receptor (VEGFR), and MET, is used clinically to treat certain cancers, including hepatocellular carcinoma. This study aimed to assess the impact of cabozantinib on liver fibrosis and hepatocarcinogenesis in a rat model of metabolic dysfunction-associated steatohepatitis (MASH). MASH-based liver fibrosis and hepatocarcinogenesis were induced in rats by feeding them a choline-deficient, L-amino acid-defined, high-fat diet (CDAHFD) for eight and 16 weeks, respectively. Cabozantinib (1 or 2 mg/kg, daily) was administered concurrently with the diet in the fibrosis model and after eight weeks in the carcinogenesis model. Treatment with cabozantinib significantly attenuated hepatic inflammation and fibrosis without affecting hepatocyte steatosis and ballooning in CDAHFD-fed rats. Cabozantinib-treated rats exhibited a marked reduction in α-smooth muscle actin+ activated hepatic stellate cell (HSC) expansion, CD68+ macrophage infiltration, and CD34+ pathological angiogenesis, along with reduced hepatic AXL, VEGF, and VEGFR2 expression. Consistently, cabozantinib downregulated the hepatic expression of profibrogenic markers (Acta2, Col1a1, Tgfb1), inflammatory cytokines (Tnfa, Il1b, Il6), and proangiogenic markers (Vegfa, Vwf, Ang2). In a cell-based assay of human activated HSCs, cabozantinib inhibited Akt activation induced by GAS6, a ligand of AXL, leading to reduced cell proliferation and profibrogenic activity. Cabozantinib also suppressed lipopolysaccharide-induced proinflammatory responses in human macrophages, VEGFA-induced collagen expression and proliferation in activated HSCs, and VEGFA-stimulated proliferation in vascular endothelial cells. Meanwhile, administration of cabozantinib did not affect Ki67+ hepatocyte proliferation or serum albumin levels, indicating no negative impact on regenerative capacity. Treatment with cabozantinib also reduced the placental glutathione transferase+ preneoplastic lesions in CDAHFD-fed rats. In conclusion, cabozantinib shows promise as a novel option for preventing MASH progression.

Factors Affecting Intraoperative Blood Transfusion Requirements during Living Donor Liver Transplantation.

Background: Intraoperative blood transfusion (IOBT) during liver transplantation (LT) has negative outcomes, and it has been shown that an increasing number of these procedures may no longer require IOBT. Regarding living donor liver transplantation (LDLT), the literature on the pre-transplant predictors of IOBT is quite heterogeneous and deficient. In this study, we reviewed our experience of IOBT among a homogenous cohort of adult right-lobe LDLTs. Methods: We conducted a retrospective analysis of prospectively collected data on adult LDLT recipients between January 2018 and October 2023. Two groups were constructed (No-IOBT vs. IOBT) for the exploration of pre- and intraoperative predictors of IOBT using univariate and multivariate analyses. An ROC curve analysis was applied to identify possible cut-offs. The one-year post-LDLT overall survival was compared using the Kaplan-Meier method. A p-value < 0.05 was considered statistically significant. Results: A total of 219 adult LDLT recipients were enrolled. The No-IOBT (n = 56) patients were mostly males (p = 0.016), with higher preoperative levels of HGB (p < 0.001), fibrinogen (p = 0.005), and albumin (p = 0.007) and a lower incidence of pre-transplant upper abdominal surgery (p = 0.017), portal vein thrombosis (p = 0.04), hepatorenal syndrome (p = 0.015), and ascites (p = 0.02) than the IOBT group (n = 163). The No-IOBT group had a shorter anhepatic phase (p = 0.002) and received fewer intravenous crystalloids (p = 0.001). In the multivariate analysis, the pre-transplant HGB (p < 0.001), fibrinogen (p < 0.001), and albumin (p = 0.04) levels were independent predictors of IOBT, showing the following cut-offs in the ROC curve analysis: HGB ≤ 11.5 (AUC: 0.800, p < 0.001), fibrinogen ≤ 125 (AUC: 0.638, p = 0.0024), and albumin ≤ 3.6 (AUC: 0.663, p = 0.0002). These were significantly associated with the No-IOBT group. The one-year overall survival of the No-IOBT and IOBT groups was 100% and 83%, respectively (p = 0.007). Conclusions: IOBT during LDLT is associated with inferior outcomes. The increased need of IOBT during LT can be predicted by evaluating serum levels of hemoglobin, albumin and fibrinogen before liver transplantation.

Serum Biochemical Factors as Indicators of Osteoporosis: A Cross-Sectional Study

Introduction: Osteoporosis is a bone condition that disrupts bone structure, reduces its strength, and increases the risk of fractures. While osteoporosis is commonly recognized as a disorder affecting the elderly, it can also develop in younger adults and be accompanied by other disorders. Screening individuals and diagnosing those at higher risk of osteoporosis early may significantly reduce the likelihood of complications and associated costs. Objective: Serum biochemical factors are rather easily measured and accessible, making them valuable as predictive indicators for the prognosis and early diagnosis of osteoporosis. However, there is not enough evidence about possible relationships between these factors and osteoporosis in different bones. Methods: In this descriptive cross-sectional study, we analyzed osteoporotic indices, including bone marrow density (BMD), T-score, Z-score, and standardized BMD, in a large population of individuals at risk of osteoporosis. We then investigated potential relationships between biochemical values and osteoporosis indices in the evaluated subjects. The collected data were analyzed using the Kruskal-Wallis test and Spearman correlation coefficient methods. Results: A total of 1104 patients were enrolled, with 87.7% being female and 12.3% male. The mean age of the patients was 56.48 ± 11.62 ( ± SE) years. Among them, 251 patients had normal bone density, while 556 patients had osteopenia, and 270 patients had osteoporosis. The Kruskal-Wallis analysis demonstrated that serum levels of Calcium (p=0.014), Phosphorus (p =0.002), and Vitamin D3 (p =0.045) were positively associated with the risk of osteoporosis, whereas serum albumin (p =0.005) and Alkaline phosphatase (p =0.002) levels were negatively associated. Additionally, the Spearman correlation coefficient showed a negative association between hemoglobin levels and BMD in both the spine (p =0.046) and femur (p =0.049). Conclusion: Serum levels of biochemical factors may serve as primary predictive markers for the early diagnosis of individuals at higher risk of osteoporosis and bone fractures. In addition to factors involved in calcium homeostasis, serum levels of albumin and hemoglobin are also associated with BMD scores and the development of osteoporosis.

Relationships between human serum albumin levels and septic shock, in-hospital, and out-of-hospital mortality in elderly patients with pneumonia in different BMI ranges

ObjectiveThis retrospective cohort identified the association of human serum albumin (HSA) with adverse outcomes (septic shock, in-hospital and out-of-hospital mortality) in elderly hospitalized patients who have community-acquired pneumonia (CAP) and specific body mass index (BMI).Materials and methodsThis research included hospitalized CAP individuals (≥ 60 years) and was conducted at a teaching hospital in western China. All the patients were categorized into three populations based on two BMI cutoff values (18.5 kg/m2 and 24 kg/m2). The data was acquired from medical records, local government mortality databases, and telephone interviews. Binomial logistic regression analysis was used to explore the associations between low HSA and septic shock and in-hospital mortality, and Cox regression analysis was used to explore the association between low HSA and out-of-hospital mortality.ResultsA total of 627 patients were included in the analysis of in-hospital death and septic shock, and 431 patients were included in the analysis of out-of-hospital death. The study showed that 120 elderly patients with CAP (19.14%) died in the hospital, while 141 patients (32.71%) died out of the hospital, and 93 patients (14.83%) developed septic shock. No differences in in-hospital and out-of-hospital mortality were observed for BMI values < 18.5 kg/m2 or BMI ≥ 24 kg/m2, regardless of whether HSA was ≥ 40 g/l or < 40 g/l. When 18.5 kg/m2 ≤ BMI < 24 kg/m2, patients with HSA < 40 g/l had both higher in-hospital and out-of-hospital mortality compared with those with HSA ≥ 40 g/l (in-hospital death: 26.13% vs. 11.46%, p < 0.001; out-of-hospital death: 46.15% vs. 19.17%, p < 0.001). No significant differences were observed in the incidence of septic shock between patients with HSA < 40 g/l and those with HSA ≥ 40 g/l either in the overall population or when the BMI values were divided according to the cutoff values of 18.5 kg/m2 and 24 kg/m2. After further logistic regression analysis and adjustment for potential confounders, the results showed that when 18.5 kg/m2 ≤ BMI < 24 kg/m2, elderly CAP patients with HSA < 40 g/l had a higher risk of in-hospital and out-of-hospital mortality compared with those with HSA ≥ 40 g/l (in-hospital death: HR = 1.964, 95%CI = 1.08–3.573; out-of-hospital death: HR = 2.841, 95%CI = 1.745–4.627).ConclusionsHSA levels can predict the risk of in-hospital and out-of-hospital mortality in elderly patients with CAP and normal BMI values. However, HSA cannot predict the risk of septic shock in elderly patients hospitalized with CAP, irrespective of their BMI classification.

Geraniol intake improves age-related malnutrition in mice.

Geraniol is an acyclic monoterpenoid that is abundant in many plants, including rose, lemongrass, and lavender. As geraniol has various beneficial functions, rose oil rich in geraniol is not only used for aromatherapy but also as a supplement to promote health benefits. However, the beneficial effects of geraniol on age-related pathologies are unknown. In this study, we aimed to clarify the effects of geraniol intake on age-related pathologies. We orally administered geraniol to aged mice (age: 24-29 months) five times a week for 4 weeks and sampled their blood and various organs. We investigated age-related changes in the blood and organ samples. Furthermore, we treated HepG2 cells with geraniol and examined the expression level of the ALB gene and the amount of secreted albumin in vitro. Geraniol significantly increased blood albumin, total cholesterol, and red blood cell counts, indicating an improvement in nutritional markers in aged mice. Geraniol also transcriptionally increased the Alb gene expression in the liver of aged mice. Furthermore, treatment with geraniol significantly upregulated the ALB gene expression and the secretion of albumin in the conditioned medium of HepG2 cells. Geraniol increases serum albumin levels at the transcriptional level. Geraniol intake can be an effective strategy for age-related malnutrition. Geriatr Gerontol Int 2024; ••: ••-••.

Efficacy of Postoperative Oral Nutritional Supplements in Geriatric Hip Fracture Patients Undergoing Total Hip Arthroplasty.

Background/Objectives: Geriatric hip fracture patients have an increased risk of malnutrition. Proper nutritional supply in the perioperative period is very important for their recovery. Oral nutritional supplements (ONSs) are recommended in geriatric hip fracture patients to improve dietary intake and prevent complications. This study aimed to evaluate the efficacy of postoperative ONSs after total hip arthroplasty in geriatric hip fracture patients. Methods: A retrospective study of elderly patients who underwent total hip arthroplasty for hip fracture was conducted. Data from patients who received ONSs postoperatively until hospital discharge (ONS group, n = 69) were compared with patients who did not receive ONSs (control group, n = 168). Laboratory test results, including serum protein and albumin levels, length of hospital stay, and the incidence of postoperative medical complications of the two groups, were analyzed. Results: Preoperative serum protein and albumin levels were significantly higher in the control group (p = 0.002 and p = 0.010, respectively). However, the degree of decline for both protein and albumin levels was significantly less in the ONS group (p < 0.001 for both). Serum albumin levels were significantly higher in the ONS group at postoperative two-week follow-up (p = 0.006). The length of hospital stay was shorter in the ONS group (p < 0.001). The incidence of postoperative delirium was significantly higher in the control group (p = 0.007). Conclusions: In geriatric hip fracture patients, postoperative ONSs can improve postoperative nutritional status, shorten the length of hospital stay, and reduce the incidence of postoperative delirium.

A case of protein-losing gastroenteropathy due to Sjögren's syndrome detected by foggy vision with refractive error of the intraocular lens.

A woman in her forties visited an ophthalmologist for rapidly progressive foggy vision. Naked visual acuity had decreased to 0.15, and although her eyes showed no abnormalities, internal disease was suspected and albumin 2.6g/dL was found. Protein leakage from the intestinal tract was suspected since there was no urinary protein excretion. 99mTechnetium-labeled albumin D scintigraphy showed protein leakage from the intestinal tract. A stool α1-antitrypsin clearance test showed an increase to 56.3mL/day, leading to a diagnosis of protein-losing gastroenteropathy. Blood biochemistry revealed abnormally high levels of anti-SS-A and anti-SS-B antibodies (≥ 1200U/mL and ≥ 1000U/mL, respectively). A lip salivary gland biopsy revealed lymphocytic infiltrate at least 1 focus per 2mm × 2mm > 50 lymphocytes per conduit). The Schirmer test result was 5mm/5min or less, which led to the diagnosis of Sjögren's syndrome. The serum albumin level increased with intravenous administration of methylprednisolone 50mg (1mg/kg), and the patient is currently on oral prednisolone at a gradually decreasing dose. After administration of prednisolone, visual acuity recovered to 1.2 with recovery of albumin.